Water Hygiene Management Case Study: Legionella Risk Assessment at a Residential Care Setting

H2O Comply recently carried out a detailed Legionella Risk Assessment at a small residential care property with multiple cold water storage tanks, hot water cylinders, showers and outlets used at different frequencies. Our risk assessment identified several areas where water hygiene management could be improved, including the condition and accessibility of water storage tanks, the management of infrequently used outlets and potential risks associated with shower hoses.

Following the assessment, we provided the client with a clear and prioritised action plan to help improve the management of the water system, support ongoing compliance and reduce potential risks to residents, employees and visitors.

Water hygiene is an important consideration within every residential care environment. Although this particular property was relatively small, the water system included several elements that required careful assessment.

Multiple cold water storage tanks and hot water cylinders served different areas of the building, while patterns of water use varied, according to the day-to-day needs of residents.

Some taps, showers and other outlets were used regularly, while others experienced lower levels of use. This meant that the assessment needed to consider more than the general condition of the water system.

Our assessor reviewed how water was stored, heated and distributed throughout the building, as well as how the property was occupied and managed.

Understanding the Water System

The first stage of the assessment involved reviewing the layout and operation of the hot and cold water systems.

The property contained several cold water storage tanks and hot water cylinders, creating a more involved water system than may initially be expected within a smaller residential setting.

Our assessor identified the principal parts of the system and considered how water travelled from storage through to the various taps, showers and other outlets around the building.

Understanding this arrangement is important because different parts of a property can experience very different patterns of water use.

Communal facilities may be used regularly throughout the day, while outlets within vacant rooms, spare facilities or less frequently occupied areas may remain unused for longer periods.

Changes in occupancy can also affect water use. A room that is occupied and used every day may later become vacant, meaning the taps or shower within that area receive significantly less use.

The Legionella Risk Assessment therefore, considered both the physical water system and the way the building operated.

This provided the client with a clearer understanding of the areas requiring attention and the ongoing management measures that could help maintain good water hygiene.

Reviewing Cold Water Storage Tanks

The condition of the property’s cold water storage tanks formed an important part of the assessment.

Water storage tanks should be appropriately maintained and accessible so their condition can be inspected and any required maintenance can be carried out.

During the assessment, several areas relating to tank condition and accessibility were identified for improvement.

Restricted access can make routine inspections more difficult. It may also create challenges when maintenance, cleaning or repairs are required.

Where access is limited, the responsible person may find it harder to monitor the condition of the tank and identify changes before they develop into more significant concerns.

Our assessment considered the accessible condition of the tanks and highlighted areas where further attention would be beneficial.

Rather than providing the client with a general statement that improvements were needed, the findings were explained within a structured action plan.

This helped the client understand which recommendations should be considered a priority and which could be incorporated into longer-term property maintenance.

The purpose of this approach was to make the assessment practical and manageable.

A detailed report should provide a clear route forward, allowing the responsible person to plan work and understand how each recommendation relates to the wider management of the water system.

Identifying Infrequently Used Outlets

The assessment also identified outlets that experienced lower levels of use.

Infrequently used taps and showers can require additional management because water may remain within sections of pipework for longer periods.

The presence of a low-use outlet does not automatically mean there is a serious water hygiene problem. However, these outlets should be identified so appropriate Legionella control measures can be introduced.

Within residential care settings, patterns of use can change regularly.

Bedrooms may become temporarily vacant, residents may use communal facilities rather than en-suite bathrooms, and some outside outlets may only be required occasionally.

Without a clear process in place, changes in water use can be easy to overlook.

Our assessment helped the client identify where additional management may be required and provided recommendations suitable for the way the property operated.

This included considering how relevant outlets could be incorporated into an ongoing flushing and monitoring programme.

The recommendations were designed to provide a consistent approach without creating unnecessary work for care employees.

By identifying low-use outlets and assigning clear responsibilities, the client could take a more structured approach to maintaining water movement throughout the property.

Assessing Showers and Shower Hoses

Showers were another important area considered during the Legionella Risk Assessment.

Shower heads and hoses can require regular attention as water can remain within the equipment between uses. Over time, deposits may also accumulate within shower components.

The assessment identified areas where shower hose management could be improved and provided recommendations relating to ongoing inspection, cleaning and maintenance.

Any programme introduced within a care setting also needs to reflect the practical requirements of residents. Flexible shower hoses may be essential for accessibility and assisted washing, meaning water hygiene recommendations must work alongside the needs of the people using the facilities.

Our recommendations were therefore based on the specific equipment and circumstances found at the property rather than applying a generic approach. The client was provided with clear guidance to help manage shower equipment as part of the wider water hygiene programme.

Where cleaning, maintenance or replacement was recommended, this was included within the action plan so the work could be prioritised appropriately.

Reviewing Existing Water Hygiene Controls

As part of the assessment, H2O Comply also reviewed the water hygiene controls already in place.

Many organisations carry out regular maintenance activities but may not always have a fully documented programme explaining what needs to be completed, when checks should take place and who is responsible.

A Legionella Risk Assessment provides an opportunity to review existing procedures and determine whether additional controls or clearer records may be beneficial.

The assessment considered how the client currently managed the water system and highlighted areas where procedures could be strengthened.

In some cases, the required improvement may involve physical maintenance. In others, clearer monitoring, improved record keeping or more defined responsibilities may be appropriate. The aim is to develop a proportionate approach based on the building and its water system.

A small residential care property does not necessarily require the same management arrangements as a large hospital or extensive healthcare complex.

However, the presence of multiple storage tanks, hot water cylinders, showers and changing patterns of outlet use meant that a structured water hygiene programme remained important.

Providing a Prioritised Action Plan

Following the site assessment, H2O Comply prepared a detailed report setting out the findings and recommended actions.

The client received a prioritised plan covering the condition and accessibility of storage tanks, the management of infrequently used outlets, shower hose risks and ongoing water hygiene controls.

Prioritising the findings made it easier for the client to understand which areas required attention first.

It also allowed any remedial work to be planned around the operational requirements of the care property.

Care settings operate continuously, and maintenance needs to be managed in a way that minimises disruption to residents and employees.

A clear action plan allows work to be organised rather than addressed reactively.

The report also provided a useful reference point for future monitoring and reviews.

As changes are made, actions can be recorded, and the effectiveness of the water hygiene programme can be assessed over time.

Supporting Safer Water Management in Residential Care

This case study demonstrates why the size of a property does not always reflect the complexity of its water system.

Although the residential care setting was relatively small, multiple storage tanks, hot water cylinders and changing patterns of outlet use created several areas that required consideration.

By focusing on the specific conditions found at the property, H2O Comply was able to provide recommendations that were proportionate, achievable and relevant to the care environment.

The client received more than a list of observations. The final report provided a structured plan to support ongoing water hygiene management and help the responsible person understand the actions required.

Regular monitoring, suitable maintenance and periodic reviews can help ensure that water hygiene controls continue to reflect the needs of the property.